Bony changes occur in the skeleton of the midcheek with advancing age for both males and females. The anterior maxillary wall retrudes in relation to the bony orbit, which maintains a fixed anteroposterior dimension at its midpoint. These changes should be considered in addressing the aging midface.
Although much is written concerning breast augmentation, few authors have addressed preoperative chest wall analysis as it pertains to postoperative outcome. In the present study, 100 patients were randomly selected, underwent bilateral augmentation, and were examined retrospectively by four independent physicians using standardized preoperative photographs. Each patient was examined for ptosis and asymmetry of the nipples, breast mound, and chest wall. Results revealed significant asymmetries in all parameters. Nipple-areola complex asymmetry was present in 24 percent (nipple/areola size) and 53 percent (nipple position) of the women. Mound asymmetry was noted in 44 percent (volume), 29 percent (base constriction), and 30 percent (inframammary fold position) of the women, and finally, 29 percent of the women had grade I to III ptosis. Chest wall asymmetry was observed in 9 percent of the women. Overall, 88 percent of the women had some degree of asymmetry, and 65 percent of the women had more than one parameter of asymmetry. These findings underscore the importance of developing a systematic preoperative breast and chest wall analysis that can be individualized for each patient. The resulting asymmetries should then be discussed with the patient, along with the potential for continued or even more pronounced asymmetry postoperatively.
A double blind randomized trial of two non-ionic contrast media--iopamidol and iopromide--was performed on 101 patients undergoing left ventriculography and coronary angiography. Both products performed well in the trial and there were no statistically significant differences in side effects, cardiovascular parameters, blood analysis or film quality between the two products.
Digital X-ray imaging techniques have achieved wide-spread acclaim in general vascular diagnosis and in the support of interventional procedures. However, in cardiac angiography, acceptability of digital imaging until recently, has been less enthusiastic. To a large extent this has reflected the effectiveness of cine fluorography and the exacting performance standards that it sets to any competing technique. Whereas cine fluorography provides rapid acquisition of dynamic sequences of high (spatio-temporal) fidelty images, the review of these images has to be retrospective and in practice it is necessary to rely heavily on the modest image quality provided by TV fluoroscopy for the on-line evaluation of the procedure.
Early attempts at digital cardiac imaging based upon digital subtraction angiography (DSA) produced results of widely inconsistent quality. This was partly because of the inferior specification of the equipment used at that time. In addition, however, the dynamic nature of the heart itself sets limits to the precision with which subtractive imaging could be performed. Nonsubtractive, or grey-scale, digital imaging on the other hand promised several practical advantages over DSA for cardiac studies, provided that the quality of the images could be enhanced using digital imaging techniques (Rouse et al, 1986).
The recent introduction of extremely fast but economical analogue to digital converters and microprocessors now means that the contest between digital and cine fluorography in cardiac imaging can begin in earnest. Viable digital imaging systems which are custom designed for cardiac applications are now available.
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